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Technical Business Analyst - Healthcare Billing

Quadax, Inc.

Middleburg Heights, OH

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JOB DETAILS
JOB TYPE
Part-time
SKILLS
Acceptance Testing, Agile Programming Methodologies, Analysis Skills, Billing, Business Analysis, Change Control, Change Management, Coding Standards, Communication Skills, Content Management Systems (CMS), Current Procedural Terminology (CPT), Data Analysis, Data Modeling, Data Quality, Data Structures, Data Visualization Tools, Database Report Tools, Decision Support, Detail Oriented, Documentation, Gap Analysis, HIPAA (Health Insurance Portability and Accountability Act), HL7 (Health Level 7), Healthcare Administration, Healthcare Common Procedure Coding System (HCPCS), ICD-10, Identify Issues, Information Systems/Technology IS/IT Administration, JSON, Medical Billing, Power BI, Problem Solving Skills, Process Flow, Process Improvement, Progress Reports, Project Planning, Quality Assurance, Reconciliation, Regulatory Compliance, Reporting Dashboards, Resource Management, SQL (Structured Query Language), Scrum Project Management and Software Development, ServiceNow, Software Development, System Integration (SI), Systems Analysis, Technical Writing, Test Case, Trend Analysis, Use Cases, Workflow Analysis
LOCATION
Middleburg Heights, OH
POSTED
10 days ago

Location: Middleburg Heights, OH

Department: Integrations Team / Application Development

Reports To: Director of Application Development

Job Type: Full-Time / Hybrid 

Position Summary:

We are seeking a detail-oriented and technically proficient Technical Business Analyst with expertise in healthcare billing systems to join our team. This role will serve as a critical link between business stakeholders and IT, ensuring that billing processes are optimized, compliant, and aligned with organizational goals.

Key Responsibilities:


General Business Analysis

  • Gather, analyze, and document business and technical requirements.
  • Translate business needs into functional specifications and user stories.
  • Conduct gap analyses and recommend process improvements.
  • Facilitate stakeholder meetings to define project scope and objectives.
  • Support QA and UAT efforts by validating test cases and outcomes.


Technical & Systems Analysis

  • Analyze system capabilities and recommend enhancements.
  • Create and maintain documentation including process flows, data models, and integration maps.
  • Troubleshoot and resolve system issues related to billing workflows.


Healthcare Billing-Specific Functions

  • Analyze and optimize workflows related to medical billing and client specific Use Cases.
  • Knowledge regarding compliance with HIPAA, CMS guidelines, and payer-specific billing requirements.
  • Monitor and analyze order and claim data received from our client.
  • Support integration of billing systems.
  • Assist in audit and reconciliation processes by providing system data and documentation.


Reporting & Data Analysis

  • Develop and maintain dashboards and reports using tools like SQL or Power BI.
  • Perform data analysis to support decision-making and identify trends in billing performance.
  • Ensure data integrity and consistency across systems.


Project & Change Management

  • Contribute to project planning, timelines, and resource allocation.
  • Support change management initiatives including training and documentation.
  • Track and report on project progress, risks, and issues.
  • ServiceNow event logging and verification of change control compliance


Qualifications:


Required:

  • Bachelor’s degree in Business, Information Systems, Healthcare Administration, or related field.
  • 3+ years of experience as a Business Analyst, preferably in healthcare or billing systems.
  • Strong understanding of healthcare billing processes, coding standards (ICD-10, CPT, HCPCS), and payer requirements.
  • Proficiency in SQL and data visualization/reporting tools.
  • Excellent communication, analytical, and problem-solving skills.


Preferred:

  • Familiarity with HL7 and JSON data structures.
  • Familiarity with HIPAA and CMS compliance standards.
  • Agile/Scrum experience.


Working Conditions:

Hybrid (2 days onsite per week)

About the Company

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Quadax, Inc.